Provider Demographics
NPI:1437577525
Name:DELMONICO, CRISTINA (RN)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:DELMONICO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-2109
Mailing Address - Country:US
Mailing Address - Phone:631-334-6082
Mailing Address - Fax:
Practice Address - Street 1:39 CHAUNCEY LN
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-3504
Practice Address - Country:US
Practice Address - Phone:631-356-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-04
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY683287-1163W00000X
NY404291363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse